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Professional and family caregivers’ attitudes towards involuntary treatment in community‐dwelling people with dementia [2018]

Aims
To gain insight into professional and family caregivers’ attitudes towards involuntary treatment in community‐dwelling people with dementia (PwD).

Background
The number of PwD with complex care needs living at home is increasing rapidly. In some situations, caregivers provide care against the will of PwD, referred to as involuntary treatment, which includes non‐consensual care, psychotropic medication and physical restraints.

Design
A cross‐sectional study.

Methods
A total of 228 professional (nursing staff, general practitioners (GPs) and other health care professionals such as physical therapists and psychologists) and 77 family caregivers of PwD completed the Maastricht Attitude Questionnaire – Home Care. This questionnaire measures attitudes towards involuntary treatment and perceived restrictiveness of and experienced discomfort in using involuntary treatment. Data were collected in the Netherlands between June – November 2016.

Results
Family caregivers and GPs had more positive attitudes towards involuntary treatment than nursing staff and other health care professionals, indicating that they are more accepting of involuntary treatment. A more positive attitude was associated with higher perceived caregiver burden and being a family caregiver. Family caregivers and GPs found the use of involuntary treatment less restrictive and indicated feeling more comfortable when using these measures.

Conclusion
It is important to account for the differences in attitudes and foster dialogue among professional and family caregivers to find common ground regarding alternatives to involuntary treatment. These results will inform the development of an intervention that aims to prevent involuntary treatment in home care.

Angela M H J Mengelers Michel H C Bleijlevens Hilde Verbeek Elizabeth Capezuti Frans E S Tan Jan P H Hamers

The Journal of Advanced Nursing, 30 August 2018

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